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Raffaele Parrozzani, Elisabetta Pilotto, Alessia Dario, Edoardo Midena; Prompt Versus Delayed Intravitreal Triamcinolone Injection for Serous Retinal Detachment Secondary to Posterior Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3280.
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To evaluate prompt (intraoperative) versus delayed intravitreal triamcinolone acetonide (IVTA) injection (4mg/0.1mL) as adjuvant treatment of serous retinal detachment (SRD) secondary to posterior uveal melanoma.
Thirty-two consecutive patients affected by posterior uveal melanoma with large SRD (>10 mm in LBD) treated by prompt IVTA injection at the time of plaque brachytherapy (I-125) were included in this retrospective case-control study. Controls included thirty-two patients treated by delayed (more than 3- and less than 9-months after brachytherapy) IVTA injection because of large SRD at time of brachytherapy. Controls were matched with cases for age, gender, initial tumor thickness and tumor location (choroidal vs ciliary body). All patients underwent a 1-, 3-, 6-month follow-up examination, and every 6 months thereafter, including fundus photography and A/B scan ultrasonography. Follow-up was longer than 24 months.
Follow-up was 37±7 months. Controls underwent IVTA injection 5±1.7 months after brachytherapy. Complete SRD regression was documented in eighteen prompt-treated patients (56%) vs eleven delayed-treated patients (34%) (p>0.05). Early-onset steroid-induced cataract was observed in four prompt-treated patients (12%) vs three delayed-treated patients (9%) (p>0.05). No steroid-induced increased intraocular pressure, nor others short or long term side effects were documented.
Intraoperative IVTA injection substantially increases the probability of earlier and complete serous retinal detachment resolution after brachytherapy of posterior uveal melanoma. These results suggest the existence of a time-limited corticosteroids efficacy in a subgroup of uveal melanoma patients with large serous retinal detachment.
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